Mechanisms of Pupillary Block-Reply

In Reply. —The questions raised by Dr Mackool have alerted us to the fact that the whole issue of differentiation between pupillary block and malignant glaucoma may indeed be confusing. This issue has always stimulated interesting controversies among colleagues. It is important to realize that most definitions were originally described and mechanisms arrived at in an era in which extracapsular cataract extraction and posterior chamber intraocular lens implantation were not practiced yet, or were just beginning.1The shape and topographical relationship of the crystalline lens to the adjacent structures are quite different from those of a pseudophakos, especially with regard to thickness and diameter. Also, in many cases of closed-system extracapsular cataract extraction, disturbance of the vitreous is kept to a minimum. Following are anatomical considerations after extracapsular cataract extraction. If extensive adhesions develop between the posterior capsule and the iris, the posterior chamber might collapse altogether. Should